Panita Chiemmongkoltip

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Practice address

511 Dundee Ave
East Dundee, IL 60118-1642

Phone

(847) 844-3274

Fax

(847) 844-3275

NPI assigned

Jan 30, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: pchiemmongkoltip288432@direct.myadvocateaurora.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Medical Care Inc

  • Federally Qualified Health Center (FQHC)
  • Arlington Heights, IL
  • NPI 1497181697
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548306012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N DRYDEN AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600044918",
            "telephone_number": "847-368-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 DUNDEE AVE",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601181642",
            "telephone_number": "847-844-3274",
            "fax_number": "847-844-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIEMMONGKOLTIP",
        "first_name": "PANITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan James Brongiel, M.D.
• Aaron Bush, MS, MHA
• Kayla Camp
• Belgica Johana Cardoso
• Center for Chiropractic and Natural Medicine SC
• Kendra Clark
• Kirsten Sandra Cook
• Amish V Desai, D.D.S.
• Lindsay Dort
• Russell Dumas, BSN, RN

• Pediatrics Physician in East Dundee, IL
• Providers in East Dundee, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.